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How is hysteroscopy performed?
There are a number of different sizes and types of hysteroscopes available, depending upon the type of procedure that is required. Some hysteroscopes are combined with instruments that allow surgical manipulation and removal of tissues if necessary.
Hysteroscopy may be performed in an outpatient surgery center or a hospital operating room, or a physician's office. A number of different methods for anesthesia and pain control may be used, depending upon the individual situation. Sometimes, hysteroscopy using narrow-diameter hysteroscopes that do not require dilation of the cervical opening can be performed without anesthesia. In other cases, a local anesthetic can be applied topically or given by injection. In certain cases, a regional or general anesthetic may be recommended.
A vaginal speculum is often inserted prior to the procedure to facilitate insertion of the hysteroscope through the uterine cavity. Depending upon the exact type of hysteroscope that is used, dilation of the cervical opening with surgical instruments may be necessary. After insertion of the hysteroscope, fluid or gas is injected to distend the uterine cavity and allow for better visualization.
Hysteroscopy should not be performed if a woman is pregnant or has an active pelvic infection. It is also not recommended if a woman has known uterine or cervical cancer. Certain conditions (abnormal position of the uterus, obstruction of the cervical canal or uterine cavity, scarring or narrowing of the cervical opening) may make hysteroscopy more difficult or impossible to perform in certain cases.